Paper

Syndemic Theory and Its Use in Developing Health Interventions and Programming: A Scoping Review

September 12, 2024

The published paper can be found at Springer Link. If you are not able to access the full paper from the journal, please feel free to contact the article’s first author, Simon Outram, at simon.outram@ucsf.edu.

Authors

Simon Outran Kimberly A. Koester Lissa Moran Wayne T. Steward Emily A. Arnold

Title: Syndemic theory and its use in developing health interventions and programming: a scoping review

Syndemic Theory is a way of understanding or framing how two or more diseases occur together, how these diseases interact, and the social conditions which create or allow these interactions to continue. Syndemic theory has become increasingly influential for understanding the relationship between HIV, co-morbidities such as mental health, and associated social inequalities. The purpose of this scoping review was to examine how syndemic theory has been put into practice in respect to HIV-related health interventions or programs.

We Asked: What examples are there of Syndemic theory operating in HIV health programs?

Is there evidence of the theory being put into practice?
How do you put the theory into practice?

We Found: Lots of studies use the word ‘syndemic’ but very few engage with the theory of Syndemics

Lots of references – 963. Almost all were excluded.

In the main they:

Employed syndemics as term meaning variable, disease, or morbidity.
Made little or no attempt to engage with theory of syndemics.
Employed syndemic theory as background to the intervention
Provided recommendations for employment of theory in future only

Very few studies met the criteria for inclusion – 11

7 behavioral interventions (primarily counselling/motivational interviewing to reduce HIV risk).
1 behavioral intervention matched with ‘syndemic’ data (such as ever experiencing trauma).
2 data interventions informing policy through provision of new information.
1 broadly based community intervention employing community and family based interventions to reduce HIV risk and empower communities and individuals.

We Concluded: It’s tough to put the theory into practice. But it is possible.

The broad use of syndemic as a term is positive as it heightens awareness of biological and social interaction (however, there are problems with over-using the term).

The bias towards individually-focused studies means we miss some important things (we need to focus more on community action and upstream interventions).

There is a place for a loose version of syndemics to stimulate interventions (but still maintain a holistic approach to health).

A true syndemic intervention requires time (more time than most funded research projects can provide).